今日药学

2021, v.31(06) 460-464

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曲美他嗪治疗心绞痛的有效性、安全性和经济性评价:基于快速卫生技术评估
Effectiveness, Safety and Economic Evaluation of Trimetazidine for Angina Pectoris: A Rapid Health Technology Assessment

苏晓敏;闫佳佳;冯钰舒;胡夕芸;李佳;
SU Xiaomin;YAN Jiajia;FENG Yushu;HU Xiyun;LI Jia;Department of Pharmacy, the First Affiliated Hospital of Sun Yat-sen University;Xin Hua College of Sun Yat-sen University;

摘要(Abstract):

目的基于快速卫生技术评估方法,评估曲美他嗪治疗心绞痛的有效性、安全性和经济性,为临床合理使用曲美他嗪提供循证依据。方法通过计算机检索PubMed、Embase、The Cochrane Library、CNKI、Wanfang等数据库,检索时限均从建库至2020年12月,收集曲美他嗪治疗心绞痛的卫生技术评估(HTA)报告、系统评价/Meta分析和药物经济学研究,按照纳入排除标准筛选文献、提取资料和评价质量,对研究结果进行全面分析后得出结论。结果最终纳入13篇系统评价/Meta分析和3篇药物经济学研究。评估结果显示单用或联用曲美他嗪治疗心绞痛可有效降低心绞痛发作频率,减少硝酸甘油消耗量、心肌总缺血时间,改善心电图情况、心功能情况、运动耐受性,不增加不良反应发生率,且具有成本效果优势,但因目前可获得的文献质量偏低,仍需进一步研究。结论基于目前可获得的证据支持曲美他嗪治疗各型心绞痛是有效、安全、经济的。
OBJECTIVE To evaluate the effectiveness, safety and economy of trimetazidine in treating angina pectoris based on rapid health technology assessment method, and to provide evidence-based evidence for the rational use of trimetazidine in clinical practice. METHODS Electronic databases including PubMed, Embase, The Cochrane Library, CNKI, Wanfang and other relevant health technology assessment databases were systematically searched. From the establishment time of the database to December 2020, the health technology assessment(HTA) reports, systematic review/Meta-analyses and pharmacoeconomics studies were collectd to evaluate trimetazidine in treating angina pectoris. We selected studies according to inclusion and exclusion criteria, extracted data, assessed the quality, and then made the conclusions after comprehensive analysis of the evidence. RESULTS 16 studies were finally selected, including 13 systematic reviews/Meta-analyses and 3 economic studies. The evaluation results showed that trimetazidine monotherapy or in combination could effectively reduce the frequency of angina pectoris, consumption of nitroglycerin and the total myocardial ischemic time, also can improve the electrocardiogram, cardiac function and exercise tolerance. Meanwhile, the incidence of adverse reactions decreased trimetazidine monotherapy or in combination showed cost-effective advantages, but due to the low quality of available literatures, further studies were still needed. CONCLUSION Trimetazidine is a cost-effective, safe and economic option in treating angina pectoris based on the current available evidence.

关键词(KeyWords): 曲美他嗪;心绞痛;有效性;安全性;经济性
trimetazidine;angina pectoris;effectiveness;safety;economy

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基金项目(Foundation): 广东省临床用药研究基金(2020ZJ08)

作者(Author): 苏晓敏;闫佳佳;冯钰舒;胡夕芸;李佳;
SU Xiaomin;YAN Jiajia;FENG Yushu;HU Xiyun;LI Jia;Department of Pharmacy, the First Affiliated Hospital of Sun Yat-sen University;Xin Hua College of Sun Yat-sen University;

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